By Will Boggs, MD

NEW YORK (Reuters Health) Sep 26 – The probiotic Lactobacillus reuteri DSM 17938 improves colic in infants who are exclusively or predominantly breastfed, a new study shows.

“Given the lack of effective therapy for infantile colic and the generally good safety profile of probiotics in otherwise healthy populations, the use of L. reuteri DSM 17938 could be discussed with caregivers,” Dr. Hania Szajewska from the Medical University of Warsaw in Poland told Reuters Health by email.

A number of therapies for colic have been tried (modified formulas, herbal teas, music, and the like), but none so far has been proven conclusively to be effective.

Encouraged by a recent double-blind randomized trial that showed improvement of colic symptoms in breastfed infants, Dr. Szajewska and colleagues compared the effectiveness of L. reuteri DSM 17938 with placebo in the treatment of 80 breastfed infants with infantile colic.

Significantly more infants in the probiotic group than in the placebo group experienced treatment success (a reduction in the daily average crying time of at least 50%) beginning at day 7 and continuing throughout the 28-day study.

At day 14, for instance, 30 of 40 kids given probiotics experienced treatment success versus only 7 of 40 in the placebo group, for a number needed to treat of 2.

Median duration of daily crying was also significantly improved by probiotic treatment at all time points after baseline.

Secondary outcomes (parental perception of colic severity and family quality of life) were also significantly better in the probiotic group than in the placebo group.

According to the September 17th report in The Journal of Pediatrics, there were no adverse events associated with either treatment.

The researchers say that possible explanations for these improvements include L. reuteri’s effects on gut motility and function, colonic sensory nerves, colon contractile activity, and pain perception, as well as possible anti-inflammatory effects.

However, as Dr. Szajewska notes, “The mechanism of action of L. reuteri for treating infantile colic has yet to be elucidated.”

“The necessity of treating this self-limiting condition may be questioned,” the authors conclude. “However, if one wants to modify the natural history of infantile colic, the use of L. reuteri DSM 17938 could be discussed with caregivers.”

“Future studies,” they add, “should clarify the role of L. reuteri DSM 17938 in the management of infantile colic in formula-fed infants.”

The study was funded by the Medical University of Warsaw, which had received a donation from BioGaia AB, the manufacturer of L. reuteri DSM 17938.
J Pediatr 2012

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